Combination of mechanical circulatory devices in cardiogenic shock

Recent results derived from the Danger Shock Trial,1 the undeniable benefits to haemodynamics, as well as the results from meta-analyses derived from retrospective studies, and the clinical wisdom of experienced users have led the clinical community to believe that MCS devices could be key in transforming the landscape of cardiogenic shock therapy. Intra-aortic balloon pump (IABP), Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) have limitations and adverse effects, but their combination might be an opportunity to overcome them.